Outcomes and performance of the tesio twin catheter system placed for hemodialysis access

PURPOSE: To assess the effectiveness of and outcomes with a twin catheter s ystem MATERIALS AND METHODS: The authors retrospectively reviewed the medical rec ords, hemodialysis records, and clinical information system data from 132 c onsecutive patients who were referred for placement of a tunneled catheter for hemodialysis access. A commercially available twin catheter system was placed in all patients. Outcomes evaluated included infection rate, complic ation rate, and catheter malfunction and failure rates. Performance paramet ers evaluated included blood flow rates, urea reduction percentages, and re circulation percentages. RESULTS: One hundred eighty-four twin catheter systems were placed in 132 p atients from January 11, 1996, to October 23, 1997. The initial technical s uccess rate was 100%. There were four immediate procedural complications: A ir emboli occurred in two patients, and prolonged bleeding necessitating in tervention occurred in two. The total number of days a catheter was in plac e was 13,200 (mean, 74.6 days). Thirty-one infections occurred in 20 patien ts (total infection rate, 0.23 episodes per 100 catheter days). Sixty-five catheters malfunctioned during the study period, 19 of which necessitated r emoval, for a rate of 0.14 episodes per 100 catheter days. The average bloo d flow rate was 281.4 mL/min (range, 117.1-405.6 mL/min; median, 295.2 mL/m in). Mean and median urea reductions were both 61%. Mean and median recircu lation was 6.1% and 3.5%, respectively (range, 0%-31%). CONCLUSION: Percutaneous placement of the tunneled twin catheter system can be performed with excellent technical success and safety and acceptable ca theter performance and outcomes for effective intermediate- to long-term he modialysis.